张权 黄煌渊 陈世益 夏军 陈文钧 姜建元 200040上海医科大学附属华山医院骨科 中华骨科杂志 1999 0 19 4


    关键词：胫骨扭转畸形骨关节炎 期刊 zhgkzz 0 临床研究 fur -->


    

【摘要 】目的通过分析髌股关节退变性关节病(patello-femoraldegenerative arthrosis,PFDA)患者的胫骨扭转畸形与髌股关节排列紊乱的关系，揭示胫骨扭转畸形诱发PFDA的可能机制。方法在PFDA患者91膝和正常人21膝的CT扫描片上测量胫骨扭转角、髌股和谐角和外侧髌股角，分析PFDA与胫骨扭转畸形、髌股关节排列的关系。进而将患者按扭转角大小分为过大畸形组、过小畸形组和正常组，分析扭转畸形与髌股关节排列紊乱、发病年龄间的关系。结果PFDA患者胫骨扭转角(27.0°±9.64°)远大于正常人群(22.2°±3.87°),差异有显著性意义(P<0.05)

    The Relationship BetweenTibial Torsional Deformity

    and Patello-femoral Instability

ZHANG Quan,HUANG Huangyuan,CHEN Shiyi,et al.

    Department of Orthopaedics,Huashan Hospital,Shanghai Medical University,Shanghai 200040

【Abstract 】Purpose To investigate therelationship between tibial torsional deformity and patello-femoral alignment in thepatients with patello-femoral degenerative arthrosis(PFDA),in order to verify thepathogenesis of PFDA caused by tibial torsional deformity.Methods CT measurements oftibial torsion,patello-femoral congruence angle(CA),lateral patello-femoralangle(LPFA)were evaluated in 91 knees suffering from PFDA and in 21 normal knees.Thepatients were divided into 3 groups,normal torsion,increased torsion and decreasedtorsion,according to the CT findings.The relationship between tibial torsional deformityand the occurrence of PFDA,or patello-femoral malalignmemt were analysed.Results Thedegree of tibial torsion in patients with PFDA was significantly greater than that innormal people(27.0°±9.64°versus 22.2°±3.87°,P<0.05).The CA in the patients wassigmificantly greater (12.3°±14.0° versus4.7°±7.3°,P<0.05)amd the LPFA in thepatients was sigmificantly smaller(10.5°±4.9°versus 13.2°±4.3°,P<0.05).As for theage of starting PFDA ,the groups with the decreased and the increaswd data weresignificantly earlier than the normal torsion group,The CA among the three groups weredifferent significantly.Conclusion PFDA had a close relationship with tibial torsionaldeformity which often associated with patello-femoral instability and made the PFDAoccurred early.It provides a baseline information for the doctors to improve theprevention and treatment of degenerative arthtosis.

     ......